Medications for Treating Incontinence

There are several medications used to treat incontinence. The main types of incontinence that respond to drug treatment are stress and urge incontinence.

However, the FDA has not approved these medications for this indication. Other treatment non-surgical and surgical options are safer and possibly more effective. The American College of Physicians (ACP) recommends first-line treatment with pelvic floor muscle training in women with stress UI. ACP recommends against treatment with systemic pharmacologic therapy for stress UI.

The medications used for urge incontinence or overactive bladder syndrome include:

• Anticholinergic agents: Anticholinergics reduce the number and strength of bladder contractions. This means these drugs are useful in managing frequency and urgency symptoms. These medicines have side effects that include dry mouth, constipation, blurred vision, palpitations, and cognitive disfunction. However, some anticholinergics are available as adhesive skin patches that have extended-release properties and are said to have fewer adverse effects. Anticholinergic drugs’ ability to reduce bladder contractions has been well established and documented. The Cochrane Collaboration* has extensively studied anticholinergic therapy in randomized placebo-controlled trials. They found the effect of anticholinergics was greater than placebo (*Rai, Cody, Alhasso, & Stewart. 2012).
• Alpha-adrenergic antagonists: This drug is often used for men with an enlarged prostate to relax the smooth muscle of the urethra and allow a better flow of urine.
• Antidepressants: Some antidepressants are used to assist people who are disturbed by nocturia, waking up multiple times overnight to go to the toilet. Other antidepressants have both an anticholinergic and alpha-adrenergic agonist action and in low doses are used to manage overactive bladder.

All of these drugs should be used in conjunction with bladder training and pelvic floor exercises. The combination of these techniques provides the best option for managing the bladder spasms that cause urge incontinence and strengthening urethral resistance in stress incontinence. Each of these incontinence medications affects people differently. You should consult your doctor to determine the best treatment for you. 

This content should not substitute medical advice from your personal healthcare provider. Please consult your healthcare provider for recommendations/diagnosis or treatment.

Rai, Cody, Alhasso, & Stewart. (2012) Anticholinergic drugs versus non-drug active therapies for non-neurogenic overactive bladder syndrome in adults, [online] Available at: Anticholinergic drugs versus non-drug active therapies for non-neurogenic overactive bladder syndrome in adults - PubMed (nih.gov) [Accessed 3 Oct. 2022].

Nocturia. https://my.clevelandclinic.org/health/diseases/14510-nocturia#:~:text=What%20is%20nocturia%3F,women%2C%20sometimes%20for%20different%20reasons [Accessed 28 Dec, 2022].

Burgio KL, Locher JL, Goode PS. Combined behavioral and drug therapy for urge incontinence in older women. J Am Geriatr Soc. 2000;48:370-4.